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At least 19 recordsLinked to original sources
PubMed1984

Human chorionic gonadotropin in maternal plasma after induced abortion, spontaneous abortion, and removed ectopic pregnancy.

Human chorionic gonadotropin (hCG) in maternal serum was analyzed by a hCG-beta-subunit, radioimmunoassay (hCG-beta-RIA) in 36 cases after induced first-trimester abortion, 35 cases of spontaneous abortion in the first trimester, and in 35 cases of ectopic pregnancy to determine the time between the apparent removal of all trophoblastic tissue by surgical intervention and the disappearance of hCG from the blood. In the cases with induced abortion, hCG was detectable from 16 to 60 days, with a median of 30 days after uterine evacuation, in those with spontaneous abortion from nine to 35 days with a median of 19 days, and in the cases of ectopic pregnancy from one to 31 days with a median of eight, five days after laparotomy d. In the cases with induced abortion, hCG was detectable from 16 to 60 days, with a median of 30 days after uterine evacuation, in those with spontaneous abortion from nine to 35 days with a median of 19 days, and in the cases of ectopic pregnancy from one to 31 days with a median of eight, five days after laparotomy d. In the cases with induced abortion, hCG was detectable from 16 to 60 days, with a median of 30 days after uterine evacuation, in those with spontaneous abortion from nine to 35 days with a median of 19 days, and in the cases of ectopic pregnancy from one to 31 days with a median of eight, five days after laparotomy and removal of the affected tube. There was a significant correlation between the initial hCG levels and the disappearance time in each series. The demonstrated disappearance times are longer than previously recognized, which should be appreciated when hCG is analyzed after termination of early pregnancy.

Abortion, Induced↗
PubMed2005

Management of spontaneous abortion.

Spontaneous abortion, which is the loss of a pregnancy without outside intervention before 20 weeks' gestation, affects up to 20 percent of recognized pregnancies. Spontaneous abortion can be subdivided into threatened abortion, inevitable abortion, incomplete abortion, missed abortion, septic abortion, complete abortion, and recurrent spontaneous abortion. Ultrasonography is helpful in the diagnosis of spontaneous abortion, but other testing may be needed if an ectopic pregnancy cannot be ruled out. Chromosomal abnormalities are causative in approximately 50 percent of spontaneous abortions; multiple other factors also may play a role. Traditional treatment consisting of surgical evacuation of the uterus remains the treatment of choice in unstable patients. Recent studies suggest that expectant or medical management is appropriate in selected patients. Patients with a completed spontaneous abortion rarely require medical or surgical intervention. For women with incomplete spontaneous abortion, expectant management for up to two weeks usually is successful, and medical therapy provides little additional benefit. When patients are allowed to choose between treatment options, a large percentage will choose expectant management. Expectant management of missed spontaneous abortion has variable success rates, but medical therapy with intravaginal misoprostol has an 80 percent success rate. Physicians should be aware of psychologic issues that patients and their partners face after completing a spontaneous abortion. Women are at increased risk for significant depression and anxiety for up to one year after spontaneous abortion. Counseling to address feelings of guilt, the grief process, and how to cope with friends and family should be provided.

Abortifacient Agents↗
PubMed1985

The moral significance of spontaneous abortion.

Spontaneous abortion is rarely addressed in moral evaluations of abortion. Indeed, 'abortion' is virtually always taken to mean only induced abortion. After a brief review of medical aspects of spontaneous abortion, I attempt to articulate the moral implications of spontaneous abortion for the two poles of the abortion debate, the strong pro-abortion and the strong anti-abortion positions. I claim that spontaneous abortion has no moral relevance for strict pro-abortion positions but that the high incidence of spontaneous abortion is not (as some claim) eo ipso any sort of justification for voluntarily induced abortion. Secondly, I show that if the strict anti-abortionist position is to be taken seriously in its insistence that prenatal life has a right to be protected by virtue of its being conceived, then it seems necessary to take measures to prevent spontaneous abortion and its presumptive causes, and this as a matter of moral obligation.

Abortion, Spontaneous↗
PubMed1993

Spontaneous abortion.

Spontaneous abortion rates vary with maternal age, but the overall incidence is approximately 2% of clinically recognized pregnancies. The incidence of clinically unrecognized loss is approximately 20%. Most early fetal losses are caused by abnormal karyotypes. Other causes include heavy caffeine use, acute alcohol consumption, and smoking. Ultrasonographic examination, which includes yolk sac configuration and crown-rump length determination can help differentiate between normal and abnormal pregnancies. After 8 weeks' gestation, hormonal assays are decreased. Conservative management of spontaneous abortions can be considered if patients have low beta-hCG levels and no residual tissue detected using ultrasonography. Complications of spontaneous abortion include maternal death, bleeding, and infection. Consideration should be given to the psychological health of women and their partners who experience spontaneous abortion, particularly if they exhibit depression, guilt, and grief reactions.

Abortion, Spontaneous↗
PubMed1996

Association of stressful life events with chromosomally normal spontaneous abortion.

Spontaneous abortion is the most common adverse reproductive outcome. Despite evidence that negative life events increase risk for a number of medical disorders, their role in pregnancy disruption has not been investigated. The present study tested an a priori hypothesis that recent negative life events increase the odds of spontaneous abortion of a chromosomally normal conceptus. Between 1984 and 1986, 192 women aged 18-42 years who visited a medical center after spontaneous abortion were interviewed about positive and negative events that had occurred in the 4-5 months preceding the loss. Subsequently, women with chromosomally normal (n = 111) and chromosomally abnormal (n = 81) losses were identified on the basis of tissue culture after interview. The women with chromosomally abnormal loss provided an estimate of the expected frequency of life events against which to compare the event frequencies of women with chromosomally normal loss. Analyses were adjusted for duration of the recall period, payment status, maternal age, education, and ethnicity. Seventy percent of the women with chromosomally normal losses reported having had one or more negative life events in the months preceding loss, compared with 52% of the women with chromosomally abnormal losses (adjusted odds ratio = 2.6, 95% confidence interval (CI) 1.3-5.2). For private patients (n = 69), the adjusted odds ratio was 4.2 (95% CI 1.3-13.4); for public patients (n = 123), it was 1.9 (95% CI 0.8-4.8). The associations held for postconception events alone and were absent for positive events. Results were unaltered by adjustment for smoking, caffeine intake, and alcohol consumption. With recall bias precluded by the study design, the strength, timing, and specificity of these associations suggest that recent negative life events play a role in chromosomally normal spontaneous abortion. Efforts to replicate these results and to elucidate underlying biologic mechanisms are required.

Abortion, Spontaneous↗
PubMed1998

Is curettage needed for uncomplicated incomplete spontaneous abortion?

Spontaneous abortion occurs in 15% to 20% of all human pregnancies. Since the late 1800s, the management of incomplete spontaneous abortion has focused on using curettage to empty the uterus as quickly as possible. This practice began to reduce blood loss and infection and has been unquestioned for 4 decades. In today's medical climate, few spontaneous abortions are the resuslt of illegal manipulation, given the availability of legal pregnancy termination. Antibiotics and transfusions are available, should complications arise in conservatively managed cases. Two prospective randomized trials suggest that conservative management may be advantageous for women who have stable vital signs without evidence of infection. They will have fewer perforations and, possibly, fewer infections and uterine synechiae with expectant or medical management. Larger trials should be undertaken to critically assess surgical evacuation compared to medical management, factoring in the psychologic impact of treatment. We believe that medical management will prove to be the most appropriate treatment for uncomplicated spontaneous incomplete abortion in the 21st century.

Abortion, Incomplete↗
PubMed1999

[Psychic coping with spontaneous abortion].

Spontaneous abortion is the early and involuntary loss of pregnancy and occurs in about 15 to 20% of all pregnancies. In this study, Filipp's heuristic model for critical life events was used to evaluate general and specific causal attributions and depressive symptoms after spontaneous abortion. A sample of 100 women was investigated at four measuring points between diagnosis and five weeks after the spontaneous abortion. The results regarding depressive symptom levels showed that two days after the miscarriage, 50% of the women were severely depressed, and five weeks later 30% were still depressed. Depressive symptoms were increased in cases of prior reproductive loss and when pregnancy was planned or desired. With regard to general causal attributions, women who tended to more internal, stable, and global attributions showed a significantly higher level of depressive symptoms than women with external, unstable, and specific attributions. In the area of specific attributions regarding pregnancy loss, the same patterns of results were found.

Abortion, Spontaneous↗
PubMed1991

Spontaneous abortion.

Spontaneous abortion, or the early termination of pregnancy without outside interference, may be caused by fetal, maternal or external factors. In many cases, a specific etiology may never be identified. A variety of clinical presentations are possible, ranging from imperceptible loss to profound life-threatening shock. Physicians should be able to diagnose and manage the six recognized types of spontaneous abortion: threatened, inevitable, incomplete, complete, missed and septic. In all cases, uterine evacuation, avoidance of complications and psychologic support of the family are important. The prognosis for a subsequent successful pregnancy is good, except in cases of habitual abortion.

Abortion, Habitual↗
PubMed1980

The psychological implications of spontaneous abortions.

Spontaneous abortion occurs in approximately 15% of obstetric patients. Our efforts to decrease bleeding and prevent infection do not take into account the emotional stress of the patient or the sense of grief and loss she might be feeling. Predominantly, the women in this study were concerned with what caused the miscarriage and why it happened. They described themselves as unhappy, depressed, hostile and anxious. In addition, the patients were often misinformed and frequently desired more accurate data. Approximately 25% answered yes to having a psychiatric problem. One-fourth of the patients had been seen earlier in their pregnancies with a threatened abortion; 17.3% had had a previous miscarriage, and 25% felt they were personally responsible for the miscarriage. Recognition of an attention to these facts enables the obstetrician-gynecologist to offer better patient care in the form of reassurance and information at several points of interaction with the patient experiencing a spontaneous abortion.

Abortion, Spontaneous↗
PubMed1987

A cytogenetic study directly from chorionic villi of 140 spontaneous abortions.

Spontaneous abortions were studied by analyzing chromosomes directly from chorionic villi. The frequency and the type of anomalies detected among 140 abortuses are in good agreement with those observed by others using conventional tissue cultures. Abnormal karyotypes were found in 48.6% of the cases. Trisomy predominated (66.2%), followed by polyploidy (22.1%), monosomy X (7.4%), and structural anomalies (4.4%). Among the trisomies, the most prevalent were of chromosome 22 (22.2%), 16 (22.2%), and 13 (9.5%). The relative frequencies of trisomies, monosomy X, and the different chromosomes involved in trisomies seem to differ between our study and those in which tissue cultures were analyzed. Our low frequency of 45,XO karyotypes and the shift to trisomies of chromosomes whose involvement increases steeply with maternal age are considered due to the approximately 3 year higher mean maternal age in our sample. The sex ratio (male to female) in chromosomally abnormal abortuses was 1.28, which is nearly identical to the 1.2 found in earlier studies. Surprisingly, in chromosomally normal abortions males were significantly outnumbered by females (sex ratio 0.76). Since maternal cell contamination cannot have influenced the sex ratio in our study, we consider it worthwhile to investigate whether failures associated with X inactivation are responsible for pregnancy wastage of some euploid female conceptuses. Knowledge of the karyotypes may serve as a prerequisite for the investigation of non-chromosomal genetic causes of pregnancy wastage.

Abortion, Spontaneous↗
PubMed1990

[Genetic aspects of early spontaneous abortion].

Spontaneous abortions are the most frequent complications in pregnancy. Especially in early pregnancy abortions are often genetically caused. The most important role between chromosomal disorders play the Trisomy, Triploidy and X0-Monosomy. Against the background of more recent findings the frequency, origins of several genetic disorders and the morphological expression in placental tissue are discussed in this review. The chromosomal situation of hydatidiform and partial mole as well as the question for the causes of malignancy-tendence of complete moles from genetic view are also considered. The importance of the knowledge of genetic disorders to correlate the microscopic placental findings and the karyotype and to support medical consultation is referred, too.

Abortion, Spontaneous↗
PubMed1999

Maternal Th1- and Th2-type reactivity to placental antigens in normal human pregnancy and unexplained recurrent spontaneous abortions.

Spontaneous abortion is the most common complication of pregnancy, but the etiology of a significant proportion of abortions is still unknown. We have examined the production of Th1- and Th2-type cytokines by women with unexplained recurrent spontaneous abortion (RSA) since it appears that successful murine pregnancy occurs in a Th2-dominant situation and that Th1-type immunity is associated with pregnancy failure. We have compared maternal reactivity toward placental antigens in women with a history of successful pregnancy with that in women with a history of RSA. This was done by coculturing maternal peripheral blood mononuclear cells (PBMC) with autologous placental cells and also by stimulating maternal PBMC with antigens from a choriocarcinoma cell line of trophoblastic origin. We detected significantly greater levels of the Th2 cytokines IL-6 and IL-10 in normal pregnancy compared to unexplained RSA and significantly higher levels of the Th1 cytokine IFN-gamma in RSA compared to normal pregnancy. These results suggest that women with normal pregnancy have a higher Th2 bias, while women with a history of RSA evince a bias toward Th1-type reactivity.

Abortion, Habitual↗
PubMed1978

Induced abortion and spontaneous abortion: no connection?

The hypothesis that spontaneous abortion is associated with prior induced abortion is tested in an epidemiologic study. The reproductive histories of a consecutive series of women admitted to hospital with spontaneous abortions were compared with those of a control series of women who delivered after 28 weeks gestation. There is no association between spontaneous abortion and prior induced abortion. The power of the analysis to detect a 30% excess in the frequency of induced abortion in cases as compared to controls is 82% at alpha = .05. The design and analysis effectually controlled for all potentially confounding factors.

Abortion, Induced↗
PubMedDate not supplied

[Coping behavior in women with miscarriage or spontaneous abortion and recurrent spontaneous abortion].

In a pilot study about medical, psychological and psychosocial factors in spontaneous and recurrent spontaneous abortions, coping strategies of 83 women were investigated and compared with a control group (n = 69). Two further subgroups were selected (31 women with recurrent spontaneous abortions and 30 without pregnancy complications). A modified form of a stress-investigation-scale (SVF from Janke et al.) was used. The results indicated that women with spontaneous abortions had increased depressive and lowered positive and cognitive coping modes. According to the hypothesis most psychological disturbances and depressive coping strategies were found in recurrent spontaneous abortions. In pregnancy depressive withdrawal, need of social support and information seeking was further increased, but emotional self-control lowered. A connection between psychological disturbances and negative coping strategies was shown. After pregnancy loss psychological support and building up positive and efficient coping strategies are therefore indicated.

Abortion, Habitual↗
PubMed1980

The effect of the intrauterine contraceptive device on the prevalence of morphologic abnormalities in human spontaneous abortions.

Spontaneously aborted conceptuses from IUD-wearing patients and prior IUD users were examined pathologically to determine the prevalence of morphologic abnormalities, which had previously been shown to correlate with cytogenetically proven heteroploidy in the conceptus. These abnormalities were never seen in the IUD-associated abortuses while occurring with the same frequency in abortuses obtained from prior IUD users and from non-users. It is concluded that the IUD by itself is responsible for the absence of heteroploidy-correlated structural abnormalities in spontaneous abortuses conceived with the IUD in situ. Relevant mechanisms underlying this IUD effect are discussed.

Abortion, Incomplete↗
PubMed1998

Uteroplacental vascular involvement in recurrent spontaneous abortion.

Spontaneous abortion is common in human pregnancy. Recent advances in pregnancy immunology and vascular biology are reviewed with emphasis upon the events associated with recurrent fetal losses. Certain treatment options used to alleviate or prevent some miscarriages are presented and discussed.

Abortion, Habitual↗
PubMed1975

[I. Induced abortions and spontaneous abortions. Psychopathological aspects apropos of a preliminary sample of 411 requests for pregnancy interruption].

Since 1975 (17th January), abortion is free and legal in France. The authors analyse 411 first cases of women requiring for an abortion (seen over a period of 11 weeks). Most of them are young women, single, many begin their sexual life. Unwanted pregnancy indicates absence of contraception by ignorance, refusal or ambivalence (never used = 184 cases). 105 women used archaic and inefficient contraceptive means. Modern contraceptive means was used by 154 women but ill applied, ill tolerated and/or discarded (pill = 103 cases, I.U.D. = 14, diaphragme = 2, condoms = 35). Unwanted pregnancy and abortion signify failure of contraception. We compare psychologic and psychopathologic features of women requiring repeated induced abortion with those of women suffering of repeated spontaneous abortion and infertility. These women have frequently (same) problems of feminine identity, bad maternal imago, absence of father, unhappy, and conflictive childhood, immature sexuality and personnality. Contradiction between conscious and unconscious wishes create the two opposite situations and intrapsychic conflicts (spontaneous abortion = conscious willing of pregnancy + unconscious rejection of unbearable pregnancy; induced abortion = strong but unconscious wish of pregancy + conscious and volontary rejection of maternity). Psychotherapy should improve sexual and affective life and in both cases. The authors compare infanticide and abortion behaviors, contraceptive means, and psychological problems of doctors who are asked abortion.

Abortion Applicants↗